Individual provider Active NPI

Kaitlyn Elizabeth McDonough, PA-C

  • Physician Assistant
  • Raleigh, NC
National Provider Identifier
1821616780
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA061682 Issued in PA
Practice address
3001 Edwards Mill Rd Ste 200
Raleigh, NC 27612-5243
Phone
(570) 703-7209
Fax
(570) 703-7325
NPI assigned
Jul 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA061682 PA Primary

Addresses

Primary practice location

3001 Edwards Mill Rd Ste 200
Raleigh, NC 27612-5243

Mailing address

3001 Edwards Mill Rd Ste 200
Raleigh, NC 27612-5243
Phone (919) 781-5600

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kmcdonough287692@direct.geisinger.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240112003288 NC Practitioner - Physician Assistant 3476970054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Raleigh Orthopaedic Clinic PAGroup PAC ID 9032012638, 125 clinicians
Novacare Outpatient Rehabilitation East, Inc.Group PAC ID 3678480290, shared by 15 NPIs, 493 clinicians

Practice addresses (Care Compare)

11200 Governor Manly Way
Suite 309
Raleigh, NC 27614-7375
Phone (919) 781-5600

1325 Timber Dr E
Garner, NC 27529-6924
Phone (919) 781-5600

201 2ND Ave
Collegeville, PA 19426-3613
Phone (610) 489-7703

3001 Edwards Mill Rd
Raleigh, NC 27612-5243
Phone (919) 863-6856

6715 McCrimmon Pkwy
Suite 205
Cary, NC 27519-1916
Phone (919) 781-5600

781 Avent Ferry Rd
Suite 110
Holly Springs, NC 27540-7776
Phone (919) 781-5600

Hospital & facility affiliations

  • Rex Hospital Hospital, Raleigh, NC, CCN 340114

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Raleigh Orthopaedic Clinic PA CurrentSince Jan 2, 2024 Accepting new patients
Geisinger Clinc CurrentSince Sep 14, 2020 Accepting new patients
Geisinger Clinic CurrentSince Sep 14, 2020 Accepting new patients

Locations

1325 Timber Dr E
Garner, NC 27529
Phone (919) 863-6856

3001 Edwards Mill Rd
Ste 200
Raleigh, NC 27612
Phone (919) 863-6852

3515 Glenwood Ave
Raleigh, NC 27612
Phone 91978156006856

100 N Academy Ave
Danville, PA 17822

3 W Olive St
Scranton, PA 18508
Phone (570) 207-4054

1800 Mulberry St
Scranton, PA 18510
Phone (570) 703-7351

Interoperability endpoints

  • Direct secure messaging: kaitlynmcdonough.raleighortho@939.direct.myezyaccess.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1821616780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 EDWARDS MILL RD STE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276125243",
            "telephone_number": "919-781-5600",
            "fax_number": "919-863-6821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 EDWARDS MILL RD STE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276125243",
            "telephone_number": "570-703-7209",
            "fax_number": "570-703-7325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONOUGH",
        "first_name": "KAITLYN",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-08",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA061682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmcdonough287692@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1800 Mulberry St",
            "city": "Scranton",
            "state": "PA",
            "country_code": "US",
            "postal_code": "185102369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.